13. PRIVACY AND CONFIDENTIALITY Flashcards
1
Q
- What are the 2 obligations when it comes to the Duty of Confidentiality?
A
- Moral Obligation
- Legal Obligation
2
Q
- What is Moral Obligation?
A
- the trust that exists in a doctor-patient relationship
depends on confidentiality
3
Q
- What is Legal Obligation?
A
- information obtained throughout the course of a
medical relationship should not be divulged
4
Q
- What information should be kept confidential?
A
- all the the patient’s identifiable information
- this information can be written, computerised, audio
recorded or kept in the memory of the doctor
5
Q
- What information is included when we say: “all of the patient’s identifiable information”?
A
- CLINICAL INFORMATION
- about the individual’s diagnosis or treatment - IMAGES OF THE PATIENT
- this can be in the form of a picture, photograph, video
or audiotape - WHO THE PATIENT’S DOCTOR IS
- what clinics the patient attends
- when the patient has appointments
- ANY OTHER INFORMATION THAT CAN IDENTIFY A
PATIENT DIRECTLY
- or indirectly
6
Q
- Answer this question with 6 points.
A
- Patient Autonomy
- Virtue Ethics
- Consequentialism
- Rights and Privacy
- Implied Promise
- Trust
7
Q
- What is meany by: “Patient Autonomy”?
A
- this is the personal information that belongs to the
patient
TO RESPECT THE PATIENT’S AUTONOMY:
- their information should not be disclosed without
consent
8
Q
- What is meant by: “Virtue Ethics”?
A
- a virtuous doctor should be sensitive
- they should be responsible
- they should be trustworthy
- they should respect the patient’s confidences
9
Q
- What is meant by: “Consequentialism”?
A
IF DOCTOR’S KEEP THE CONFIDENTIALITY:
- the patient’s trust the doctors
- the patient will be more likely to disclose important
information
10
Q
- What is meany by: “Rights and Privacy”?
A
- the patient has the right to decide who should have
access to personal information - the patient has the right to authority over their pwn
decisions
THE DOCTOR SHOULD BE ABLE TO DISTINGUISH:
- which personal information a patient wants to keep
secret
- AND which information the patient is willing to
disclose to others
11
Q
- What is meant by: “Implied Promise”?
A
- confidentiality is assumed in a doctor-patient
relationship - breaking confidentiality breaks the promise that has
been made to the patient
12
Q
- What is meant by: “Trust”?
A
- this is the precondition necessary for haring personal
information
13
Q
- What standards are an integral part of a Doctor-Patient relationship?
A
- ethical standards
- legal standards
14
Q
- What are the 3 conditions that are needed to establish a Duty of Confidentiality?
A
- INFORMATION MUST HAVE AN INHERENT QUALITY OF
CONFIDENTIALITY- this is obtained in medical practice
- INFORMATION THAT IS GIVEN IN CLINICAL CONTEXT
- implies that there is an obligation to confidentiality - UNAUTHORISED DISCLOSURE
- will have consequences
- it will cause some harm to the provider
15
Q
- What is a limit of Confidentiality according to the World Medical Association? (WMA 2006)
A
CONFIDENTIALITY CAN BE BREACHED:
- when there is a real and imminent threat of harm
- to the patient or to others
- that can only be removed by disclosing confidential
information
16
Q
- What are 5 legal frameworks regarding Confidentiality in the UK?
A
- Human Rights Act 1998
- Data Protection Act 1998
- Health and Social Care Act 2012
- Duty of Confidentiality under Law
- Notifiable Diseases and Public Health Legislations
17
Q
- What is the Human Rights Act of 1998?
A
- it revolves around the need for balance
- it looks at the right to respect private and family life
- it looks at the right to life and the right to freedom of
expression
18
Q
- What is another act that works alongside the Data Protection Act of 1998?
A
- the GDPR
- the General Data Protection Regulation 2018
19
Q
- What are the GDPR and the Data Protection Act?
A
- they are acts that control how personal information is
used by organisations, businesses and the government - they keep data safe and secure
20
Q
- What is the Health and Social Care Act of 2012?
A
- it is the regulation of patient information
21
Q
- What is the Duty of Confidentiality under Law?
A
- this is the public interest in doctor’s and their
maintenance of confidentiality - it is the public interest in protecting society or
individuals from harm
22
Q
- What are 2 examples of Notifiable diseases and public health legislation?
A
- Public Health (Infectious Diseases) Regulations 1998
- Coronavirus Act 2020
23
Q
- Answer this question.
A
- yes
- the patient would need to give consent beforehand for
the pictures to be used - this must be done even if the image is anonymised
- the patient can be identified by this picture
24
Q
- Name 4 Secondary Uses of information?
A
- THE USE OF DATA IN MEDICAL RESEARCH
- the data is anonymised
- prior patient consent is still required - CLINICAL AUDIT
- this is often undertaken under the presumption of
implied consent - CONFERENCE PRESENTATIONS
- this requires prior consent
- EDUCATIONAL PUBLICATIONS
- this requires prior consent
25
Q
- In which situations is deliberately Confidentiality often breached?
A
- in Routine Situations
26
Q
- What happens during Routine Situations?
A
- NURSES AND MEDICAL STUDENTS
- can access the patient’s record - THE USE OF INTERPRETERS
- these facilitate communication when the doctor and
patient do not speak the same language
- these facilitate communication when the doctor and
- INFORMATION
- that is shared with proxy-decision makers - INFORMATION
- that is shared with the family of the patient in critical
care or a deceased patient
27
Q
- List 4 situations in which Patient Confidentiality can be accidentally breached?
A
- Lifts and Canteens
- A&E Department Wards
- Patient Notes
- Computers, Faxes and Printers
28
Q
- How can confidentiality be breached in Lifts and Canteens?
A
- the patient’s information is discussed in crowded
places
29
Q
- How can confidentiality be breached in A&E Department Wards?
A
- there are many people in close proximity to the health
care professionals - they discuss information regarding the patient
30
Q
- How can confidentiality be breached through the Patient’s Notes?
A
- these notes can be left in an area with open access
- they might be left on the receptionists desk
- this allows other visitors and patients to see these
notes
31
Q
- How can confidentiality be breached through Computers, Faxes and Printers?
A
- the patient’s personal information can be seen on
faxes and print-outs that have not been promptly filled
in - the computer screen can be visible to the next patient
- this screen has the details of the previous patient
32
Q
- List 3 statistics involving the accidental breaching of patient confidentiality?
A
- 13/113 LIFT JOURNEYS
- consisted of hospital staff that made comments that
compromised confidentiality
- consisted of hospital staff that made comments that
- DOCTORS MADE THE MOST COMMENTS
- then allied health professionals
- and then nurses
- MOST OF THE COMMENTS
- referred to the patient’s by their initials
- or by their reason for admission
- names of the patients were used 4 times
33
Q
- What do most medical students have access to once they start their clinical training?
A
- they have access to confidential information
34
Q
- What are the 4 aspects of confidentiality that Medical Students are bound to?
A
- The same rules as qualified doctors
- The students have access to confidential information
- The students have legal responsibilities with regards
to treating confidentiality - The accidental or minor breaches of confidentiality
35
Q
- Is this a breach of confidentiality?
A
- yes
- this is a minor breach of confidentiality
- information was given that could have narrowed down
the identification of the patient
36
Q
- What other source poses a potential risk of inadvertent breaches of the patient’s information?
A
- Social Media and Networking Sites
- these are used for personal and professional
communication
37
Q
- What duty do Medical professionals and students have when it comes to social media?
A
- they have to protect the patient’s confidentiality
- they must be mindful to not disclose any identifying
pieces of information
(date, location, patient specific details)
38
Q
- How can Social media blur the boundary between private and public domains?
A
- individual pieces of information can be taken in sum
- these can help to identify a specific patient
- this is a breach of confidentiality
- the doctor can be accused of misconduct
39
Q
- In which 3 situations may confidentiality be legally and ethically breached?
A
- WHEN THE PATIENT GIVES CONSENT
- this allows clinically relevant information to be shared
with other staff members
- the other staff members can now assist in the
management of the patient
- this information can also be shared with the patient’s
family - IN INSTANCES WHERE DOCTORS ARE REQUIRED TO
BREACH CONFIDENTIALITY - CIRCUMSTANCES WHERE THERE WOULD BE
CONSIDERABLE DEFENCE
40
Q
- Does this summary make sense?
A
- yes